HomeMy WebLinkAboutPERMIT APP - 7-14-20SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
_ MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
State: _ City:
Zip: Phone State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:_
Address:
Address:
City:
City:
Zip Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that nowork or installation has commenced
prior to the issuance of a permit.
wthich is Inco 1 lict with any applicableiHom that isbuild
Associationiru esabylaws or anScovenantermit s that such
marestrictt or prohibit
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved the Florida
plans, Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR L DER ORA ORNEY BEFORE RECORDING YRSAOTICE OF CO CEMENT."
Signature of Ow / Le see/Contractor as Agent for Owner Signature of,Q ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OCOUNTY OF_IN�h
The for ting instrumgnt was acknowledged before me The forgoing instrument was acknowledged before me
this day of `)/20–Le bY this �dayof20 6
7— Y
SL u� �vv�e_ 4 �JL.n V, �1�$ c s —c t.._.
Name of pLYson making statement. Name o rson making statement.
Personally Known J OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
( oto elrR� (Signatureof b'c-S to Florida
Notary Public State of Florida
r
Commission No. DesireeNM6lotpsh Commission No. .10V� Notary Publics orde
Commis3r'ohh``GGGG 283399
6 ee N MC�q
Expires 12/11/2022 �-� A: My Cammissron GG 293399
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? Expires 12/11/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 1477 NW SWEETBAY CIR
Property Tax ID #: 4426-804-0039-000-0
Site Plan Name: FINEBURG
Project Name: FINEBURG
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES
I CONSTRUCTION INFORMATION:
Permit Number:
Building Permit Application
Commercial Residential X
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 2400
OWNER/LESSEE:
Name Emily M Fineburg
Address: 1477 NW Sweetbay Cir
City: Palm City State:
Zip Code: 34990 Fax:(772)220-1829
Phone No. (772)220-9678
E -Mail: emcintosh@elitegasco.com
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:Cheyenne Ellison
Company: Elite Gas Contractors
Address:2130 Poma Drive
City: Palm City State: FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E -Mail emcintosh@elitegasco.com
State or County License 18361
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.